I hate to be the bearer of bad news, but the Social Security Administration (“SSA”) has implemented some changes that will make it much harder to meet their definition of disability. Not all changes are negative, but SSA has made some material revisions to long-standing provisions that I expect will make it much more difficult to meet SSA’s definition of disability.
For claims filed on or after March 27, 2017, SSA will no longer give special weight to the opinion of the treating source. Historically, an opinion issued by a claimant’s treating physician was given more weight than that of other providers, including the opinions of doctors hired by SSA for consultative examinations. SSA previously provided more weight to the treating doctor’s opinion because it was thought that a doctor with a personal and longitudinal relationship with a claimant would be the best source to issue an opinion as the claimant’s limitations. While it seems logical to presume a treating doctor would know more about his/her patient than a one-time evaluator, SSA will no longer give “special weight” to the opinion of a treating physician. The negative implications of this rule change are alarming, as doctors with limited to no knowledge of a claimant’s history, diagnosis and treatment could be afforded the same consideration as a provider who has first-hand and intimate knowledge of his/her patient.
In keeping with this theme, SSA will also no longer give special weight to the opinions of other governmental agencies. The United States Court of Appeals for the Ninth Circuit, which oversees appeals in California and other western states, had previously directed SSA to give “great weight” to the opinion of the Veteran Administration’s (“VA”) decisions when it came to service-connected benefits. Other Circuits had different rules regarding this deference, but the 9th Circuit had settled law on the matter. The new changes to the Federal Regulations, however, means that VA decisions, and other decisions from differing governmental bodies, will not influence SSA when it comes to determining disability. You may have spent years trying to secure your VA benefits, but that struggle will not impact the outcome of your Social Security Disability, in spite of the fact that both SSA and the VA are Federal agencies.
Not all changes to the rules are detrimental to the claimant. SSA will now consider physicians assistants, advanced practice registered nurses, audiologists, and optometrists as acceptable medical sources. Previously, medical evidence from these individuals was not considered to be probative in Social Security Disability cases. SSA still does not consider chiropractors, social workers or registered nurses to be acceptable medical sources, however.
SSA also no longer allows individuals to submit evidence or statements more than five business days before a hearing, unless “good cause” exists. This new rule has been in effect since May 1, 2017. From what I have experienced, the Judges are being quite reasonable with this new standard. I always felt it was unprofessional to bombard a Judge with new materials a few days before a hearing, so I have always tried to cease submissions for a full week before the hearing. Now, SSA has finally made this the law. I personally have no problem with this.
Do not be alarmed. The Judges have been quite accommodating when important medical treatment or emergency medical treatment has occurred within this five day window. The Judges are also still open to keeping the record open if a major medical procedure or diagnostic study is going to take place shortly after the hearing. The Judges are finding that good cause exists in appropriate circumstances and I do not expect that to change.
Do I expect these new regulations to be the last major changes that we see affecting Social Security Disability cases in the near future? No, I do not. In fact, President Trump’s proposal to cut almost 70 billion dollars to the Social Security Disability program in the next decade, just about guarantees it. Stay tuned!
Got a question about SSDI or SSI that you need us to answer? Please check out our website at www.westcoastdisability.com . We try to provide you with helpful information on our website that will allow you to successfully navigate the Social Security Disability process. Also, feel free to email me your questions at megan@westcoastdisability.com or call me at (800) 459-3017 x 103.
